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Ramon and Diabetes

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Ramon feels a quiet satisfaction in noticing that he is slowly drifting away from his old habits of heavy internet use—especially the endless loop of Facebook reels and videos. Many of them are amusing, even clever, but most offer little that truly nourishes him. He knows he is not completely free of them yet, but he senses a shift. He is becoming more deliberate about where his time goes and how his energy is spent.

The previous day unfolded in a familiar, grounding rhythm. He began with meditation, then headed out for his morning walk. This time, he chose the old JPP park and logged more than 9,000 steps—nearly five miles. By the time he finished, it was close to 11:30 a.m. He stopped at Publix for bread and eggs, then returned home to reheat leftover nilaga from the day before. As he sat down and began browsing online, Juan knocked on the door. The timing felt just right. It had been seven days since Ramon’s tooth extraction, and he finally felt well enough to welcome visitors without worry.

With the extraction behind him and recovery going smoothly, Ramon’s thoughts had turned back to dental health. Living with diabetes, he knows he carries a higher risk for gum disease and tooth decay. A bad experience with a dentist nine years earlier still lingered in his memory, as did the consequences of years of poor blood sugar control. Even so, he feels his motivation returning. For him, dental care is not optional—it is essential. The same is true for eye health, skin integrity, and nerve protection. Diabetes, when poorly managed, is relentless: it damages nerves and blood vessels, raises blood pressure, and increases the risk of stroke and heart attack. For now, his focus is on his teeth. Over the past few days, he has immersed himself in research, comparing toothpaste and mouthwash options. Three products kept rising to the top: Crest Pro-Health Advanced, Colgate Total, and Sensodyne Pronamel.

At its core, Ramon knows this all comes down to discipline—maintaining good blood sugar control, eating mindfully, and committing to proper oral hygiene with the best tools available. Yesterday, that focus bordered on obsession, and he hopes to loosen his grip on it today.

Because of that fixation, he missed a few activities he had planned. He spent time reading a blog purely out of interest, yet afterward felt strangely incomplete. He did read, but not as many pages as he had intended. The hours he lost to researching toothpaste and mouthwash surprised him. Still, he reminds himself that progress does not have to be perfect. He walked in the park, and that counts. He also takes quiet satisfaction in how well his plants are doing.

Ramon is equally content with his decision to reduce Facebook posting to once every four days or so—just enough to reassure concerned family members that he is alive, active, and doing well. There is an unspoken pressure these days to maintain a constant digital presence, but for him, there is an important caveat. He is stepping back from social media so he can focus more seriously on writing and publishing on his anonymously authored fiction website. He wants readers to engage with his ideas, not his face. That desire has been simmering in him for a long time.

His interest lies in expressing thought through words, not in constant visibility or performance. That territory belongs to actors, influencers, and those who thrive on self-promotion—and he bears them no ill will. Everyone has the right to choose their medium. His concern is distraction, especially when it comes at the expense of personal growth and quiet accomplishment.

He is also relieved that some sources of distraction are slowly fading. He does not want an exaggerated online presence, particularly when engagement becomes an end in itself—or worse, when digital interaction replaces genuine human connection. While Ramon is not drawn to constant socializing, he is deeply curious about human behavior. He finds the richest observations in stories, spoken and written, which is why he feels an increasing pull toward books.

Since yesterday emphasized cardiovascular exercise, today is reserved for resistance training with a few leg stretches. Ramon follows standard health recommendations: at least 150 minutes of moderate cardiovascular activity per week and strength training at least twice weekly. He sees this as one of the simplest and most effective ways to reduce cardiovascular risk and slow age-related muscle loss. Walking, jogging, cycling, swimming, and dancing all count. For people who have been sedentary, are recovering from illness, or are managing chronic conditions, these guidelines provide a realistic and achievable baseline.

Those who are already active may easily exceed them. Fitness levels vary, and routines should progress accordingly. For Ramon, the message is straightforward: cardio alone is not enough. Strength training matters just as much.

Exercise settings, he believes, are deeply personal. He enjoys working outdoors, though he keeps a gym membership for days when weather makes that impractical. Some people thrive on the energy of shared spaces; others, like Ramon, prefer solitude and self-paced movement.

That is why his small yard feels like a gift. At dawn, he stepped outside and did his resistance band exercises beneath the dark canopy of bamboo and mango trees. Moonlight and stars offered just enough illumination. Everything was still—even the leaves seemed to pause. He often prefers exercising in darkness and quiet. Low light adds another layer of challenge, forcing him to rely on balance and proprioception as he moves across uneven ground, scattered rocks, and clumps of weeds. Navigating the terrain sharpens his reflexes and body awareness. He does not worry about how he looks, though he suspects the sight would amuse an observer.

He spent about forty-five minutes on the routine, including what he hesitates to call dancing—the polka. To Ramon, it feels more like a rhythmic jog set to a one-two-three count: one long step followed by two shorter ones. Depending on the tempo, it can be slow and controlled or fast enough to feel aerobic, almost like jogging. One of these days, he might even turn it into a short reel—on his own terms.

Self-Graded, Individualized Exercise: A Practical and Evidence-Based Approach for Aging Bodies

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By midday, he noticed a familiar heaviness settling in—an abrupt wave of drowsiness following his morning diabetes medications, taken to counter a carbohydrate-heavy breakfast. From experience, he recognized the pattern: a rapid rise in blood glucose followed by a medication-induced drop often produces transient fatigue and sleepiness. Clinical studies support this observation, showing that fluctuations in blood glucose—particularly post-prandial hyperglycemia followed by rapid correction—can impair alertness and cognitive function, especially in older adults with diabetes. Rather than resisting the sensation, he allowed himself to rest, knowing the fog would likely lift later in the day.

That morning, he had skipped his usual walk and instead returned to a strengthening routine he had set aside for months. Walking and gardening had provided a degree of functional conditioning, but he understood that these activities alone do not fully address muscular strength. Although he briefly considered going to a gym, poor sleep the night before—fragmented and shallow toward dawn—led him to prioritize rest. Upon waking late, he did what had become a quiet ritual: inspecting his plants.

Gardening, for him, was more than a pastime. Watching seeds germinate, cuttings sprout leaves, and seedlings mature into fruit-bearing plants evoked both curiosity and reverence. Horticultural therapy research suggests that plant-centered activities reduce stress hormones, improve mood, and foster a sense of purpose—benefits particularly valuable in older adults. For him, the process also reinforced a spiritual awareness, a daily reminder of creativity and order beyond human design.

Eventually, he unboxed a long-forgotten set of weights and brought them into the backyard. Propping his phone for recording, he began a short strengthening session using kettlebells and resistance bands. Creativity replaced conventional equipment: a potted eggplant served as a lifting weight; a decaying pine root became a step platform for leg exercises; a jacaranda trunk anchored resistance bands for upper-extremity work. Research consistently shows that resistance training does not require expensive machines—progressive loading can be achieved safely with body weight, elastic bands, and household objects.

His motivation extended beyond personal fitness. He had not posted an exercise reel in several days, and recent posts had focused on gardening. He felt compelled to return to another long-standing advocacy: demonstrating gym-free exercise options for older adults—particularly those without resources, time, or interest in competing with younger individuals in commercial gyms. His message was simple and evidence-aligned: prioritize mobility, cardiovascular activity, and moderate strength training over aesthetics or maximal performance.

At 63, he was managing chronic right shoulder and knee pain, likely degenerative in nature after decades of physically demanding hospital work. Thirty-four years of lifting, transferring, and ambulating patients—many weak, fearful, or in pain—had left their mark. Osteoarthritis and cumulative musculoskeletal stress are common among healthcare workers, and current guidelines emphasize adaptation rather than abandonment of exercise. Through compensatory strategies, modified ranges of motion, and alternative surfaces—from bed to chair to yard—he continued to move safely.

The session lasted less than twenty minutes, yet that duration was intentional. Exercise science supports the effectiveness of short bouts of resistance training, especially when consistency has lapsed. Moreover, his gardening activities—digging, lifting planters, mixing soil, raking—functioned as supplemental low-load resistance exercise. Studies confirm that such functional tasks contribute to strength maintenance, balance, and metabolic health.

Still, he remained mindful of a key principle: light activity, while better than inactivity, must eventually progress to deliver continued benefits. Research consistently shows a dose-response relationship between exercise intensity and improvements in strength, insulin sensitivity, and cardiovascular health. Two extremes, however, must be avoided—sedentary behavior on one end and excessive intensity on the other. Both are associated with increased morbidity and injury risk.

Exercise intensity is inherently subjective. What feels trivial to one individual may be exhausting to another. This variability underpins the value of self-graded exercise, a concept supported by perceived exertion scales such as the Borg Rating of Perceived Exertion. Starting at a self-assessed, tolerable level improves adherence and reduces injury risk. Consequently, prescribing a “one-size-fits-all” routine—especially for older adults—is neither practical nor evidence-based.

His own limitations shaped his program: slower walking speeds, lighter weights, longer rest periods. In contrast, another person of similar age—perhaps a lifelong athlete with fewer comorbidities—might require higher intensity or longer duration to achieve meaningful stimulus. Yet another individual may expend considerable effort simply moving from bed to bathroom, making even light exercise a challenge. High-intensity training in such cases would be unsafe.

The true risk lies not in starting light, but in remaining stagnant. Walking the same distance indefinitely or lifting the same weight year after year halts physiological adaptation. Progressive overload—incremental increases in resistance, repetitions, or duration—is essential, even if the increments are small.

Several evidence-based principles guide safe progression:

  • Gradual advancement in load, duration, or repetitions

  • Self-monitoring of symptoms, particularly in the presence of chronic conditions (e.g., uncontrolled blood glucose above 250 mg/dL, cardiac arrhythmias, COPD)

  • Medication awareness, as drugs such as beta-blockers, antidepressants, and sedatives may alter heart rate response, balance, or alertness

  • Medical clearance before advancing intensity when risk factors are present

Comparison, he knew, was a persistent psychological trap. During his rehabilitation career, he had seen patients with identical diagnoses progress at vastly different rates. Genetics, comorbidities, motivation, sleep, nutrition, and emotional health all influence recovery. Competitive tendencies—especially in aging bodies—often lead to overexertion and injury. Research supports individualized pacing and cautions against competitive framing in older or medically complex populations.

This phenomenon extends into community gyms and recreational sports, where older adults may feel compelled to match younger peers or outperform age-matched competitors. For individuals prone to comparison, exercising alone or within carefully matched groups may be safer and more sustainable.

Aging also alters recovery needs. Increased fatigue, longer rest intervals, and extended sleep duration are not signs of weakness but physiological realities. Group exercise can offer social benefits, yet requires careful consideration of pacing, instructor awareness, and individual modifications.

Ultimately, his philosophy was both practical and freeing: abandon unnecessary self-consciousness. Stop apologizing for moving slowly, lifting lightly, or resting often. Exercise is not performance—it is participation. At any age, and at any capacity, movement done with awareness, creativity, and respect for one’s limits remains not only valid, but profoundly beneficial.

  1. Exercise Progression for Adults
  2. Cortisol: A Senior’s Trusted Helper—and a Hormone to Handle With Care
  3. ANY MOVEMENT WILL DO: Rethinking Exercise, Aging, and Quality of Life
  4. Reflection Tuesday Morning
  5. The Gradual Shift
  6. Retirement: Disowning, Downsizing, Trimming
  7. Reflection on this Sunday Morning
  8. Advocacy
  9. The Mitigation
  10. Retirement Hobbies and Self Expression

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